The Importance and Requirement of Palliative Care in Newborn Intensive Care Units

Year 2018, Volume: 2 Issue: 2, 39 - 44, 15.08.2018

Şule Özel , Cüneyt Tayman , Sabriye Korkut , Esra Şükran Çakar Yaprak Engin Üstün

Abstract

Purpose: Palliative care aims to give the necessary support to
the mothers and infants / families after birth since the antenatal period. In
this study, we aimed to determine the cases those palliative care should be
given.

Materials and
Methods: Infants with birth weight ≤ 500 gr, gestational age <23 weeks and
infants with a lethal or life threatening congenital anomaly or malformation
(trismomes, syndromes, severe congenital heart disease, etc.),  severe neonatal encephalopathy sequelae,
congenital muscular disease were eligible. Fetus with severe congenital anomaly
detected in antenatal follow-ups and resulted in (termination) therapeutic
abortion was enrolled.

Results: It has been determined that birth weight ≤ 500gr and
/ or infants whose gestational age was less than 23 weeks were not alive.
Infants with trisomy 13, 18 and severe congenital heart disease, congenital
muscle disease, severe neonatal encephalopathy, severe congenital hydrocephaly
were determined to require palliative care until the end of life. It was
identified that the fetuses which detected severe congenital anomaly and other
causes during antenatal visits resulted in termination.

Conclusion: Beginning from the antenatal period, it seems that there is a need for a
national cohort that includes indications for palliative care initiation, care
/ support for family, transition to home, lifelong care and mental services /
support.

Keywords

antenatal, palliative care, newborn, trisomy, congenital anomaly

Yenidoğan Yoğun bakım Ünitelerinde Palyatif Bakımın Önemi ve Gerekliliği

Abstract

Amaç: Palyatif bakım antenatal dönemden itibaren
annelere, doğum sonrası bebeklere/ailelerine gerekli desteği vermeyi
amaçlamaktadır. Bu çalışmada palyatif bakım verilmesi gereken durumları tespit
etmeyi amaçladık.

Gereç ve Yöntem: Yenidoğan yoğunbakım
ünitesine yatırılan doğum ağırlığı ≤ 500
gr, gebelik yaşı 23 haftanın altında olan infantlar, ölümcül veya yaşamla
bağdaşmayan bir konjenital anomali ya da malformasyonu olan (trizomiler,
sendromlar, ağır konjenital kalp hastalığı vs), ağır neonatal ensefalopati
sekeli, konjenital kas hastalığı olan infantlar ve antenatal takiplerde ağır
konjenital anomali tespit edilerek gebelik sonlandırması (terminasyonu) veya
terapötik abortus yapılan gebeler çalışmaya
alındı.

Bulgular:
Doğum ağırlığı ≤ 500 gr ve/veya gebelik yaşı
23 haftanın altında olan bebeklerden yaşayan olmadığı belirlendi. Trizomi 13,18
ve ağır konjenital kalp hastalığı olan, konjenital kas hastalığı, ağır neonatal ensefalopati, ağır konjenital
hidrosefali olan bebeklerin yaşam sonuna kadar palyatif bakım gerekliliği
izlendi. Antenatal gebe takiplerinde ağır konjenital anomali ve diğer nedenler
saptanan fetusların terminasyonla
sonlandığı belirlendi.

Sonuç: Antenatal dönemden itibaren palyatif bakımı başlatma endikasyonlarını
açıklayan, ailenin bakımı/desteklenmesi, eve geçiş, ömür boyu bakım ve yas
hizmetleri/desteği gibi konuları da içeren ulusal bir rehbere ihtiyaç olduğu
görülmektedir.

Keywords

palyatif bakım, yenidoğan, antenatal, trizomi, konjenital anomali

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